DESCRIPTION (provided by investigator): The 1975 Education of All Handicapped Children Act legislated access to public education by handicapped or medically impaired children. The 1990 (revised in 1997) Individuals with Disabilities Education Act (IDEA) clarified and updated this legislation. This has resulted in an increase in the number of schoolchildren who require medications. According to national averages, one school nurse is responsible for providing medical care to 1,300 to 1,400 children. The National Association of School Nurses (NASN) recommends a ratio of 1 nurse per 750 students. To ensure that all children who require medications receive them, school nurses routinely delegate this responsibility to unlicensed assistive personnel (UAPs). In a recent survey conducted with NASN members, 649 school nurses reported that the medication error rate is 3.1 times higher when medications are administered by UAPs. Many states and school nurses recognize the need for a comprehensive multimedia training program to ensure the competency of UAPs who administer medications and the competency of the school nurses who provide the training for the UAPs. To help meet this need, we propose the development of an innovative multimedia program that will eventually consist of three primary components (1) a training-the-trainer CD-ROM program for school nurses to train UAPs in their school districts, (2) a comprehensive training CD-ROM program for UAPs about medication administration, and (3) Web-accessed adjunct materials to provide real-time updates on medications and changes to state regulations for school nurses and UAPs. This latter program may also include a manageable method for recording medication administration and errors. The program has the potential to reach a wide audience, including 92,000 public schools, over 27,000 private schools, and nearly 114,000 licensed childcare centers. Our long-term objective and primary outcomes assessment for this program is the reduction of the medication error rate among UAPs to ensure the health and well-being of children who must receive medications while attending school. In our Phase 1 research, we will conduct focus group conference calls with school nurses and UAPs to qualitatively and quantitatively assess the actual situations in schools and relate this information to the next step design and development. The CD ROM-based sample training modules will be personally tested by nurses and UAPS later in Phase 1. Both the focus groups and the in-person testing will include discussion about the need for adjunct materials and what these materials should consist of. This program, when completely developed, will be a standardized, comprehensive training program It should help to build confidence among parents, school districts and school administrators, and among school nurses, as well as among the UAPs to whom this task is often delegated and may eventually have a database management component for tracking medication errors. [unreadable] [unreadable]